Abortion clinics across England are undergoing unannounced inspections to check they are abiding by the law.
Health Secretary Andrew Lansley, who ordered the Care Quality Commission checks, raised concerns consent forms were being pre-signed – before a woman had even been seen.
Last month allegations emerged that some clinics illegally allowed women to abort because of the baby’s gender.
Mr Lansley said this was against the spirit and letter of the Abortion Act.
The work of abortion clinics came under the spotlight in February when the Daily Telegraph secretly filmed doctors and alleged some were agreeing to terminate foetuses when women did not want their baby because of its gender.
Police are still investigating the newspaper’s allegations.
But one doctor has been suspended and two more have conditions attached to their licence to practise.
Except in emergencies, the law says two doctors must certify an abortion.
However, there is no requirement for them to have actually seen the woman – only that they should have seen and assessed the necessary clinical information about her case, which could have been taken by another doctor or nurse.
“Abortion doctors provide an important service to women who are often in difficult circumstances”-Ann Furedi,
British Pregnancy Advisory Service
The requirement for two doctors’ signatures was criticised as long ago as 2007, when a report by MPs on the Commons science and technology committee recommended it be removed because of the potential for abortions to be unnecessarily delayed.
But the concerns raised by the health secretary are that doctors are signing forms before any clinical assessment has taken place, which would mean they would not know the circumstances of the woman involved.
Mr Lansley said: “I am shocked and appalled to learn that some clinics – which look after women in what are often difficult circumstances – may be allowing doctors to pre-sign abortion certificates. This is contrary to the spirit and the letter of the Abortion Act.
“The process of pre-signing certificates where the doctor does not know who the woman is for whom that certificate may be used in relation to that abortion is in itself illegal. I am not prepared to tolerate a failure to respect the law.”
He added: “The rules in the Abortion Act are there for a reason – to ensure there are safeguards for women before an abortion can be carried out. Abortion shouldn’t be undertaken lightly and the right checks and balances must be in place.”
Paul Tully, a spokesman for the Society for the Protection of the Unborn Child (SPUC) said: “We have heard about pre-signing over a number of years, although we have not seen direct evidence.”
He questioned whether even following the current rules was adequate.
“Is it sufficient for a doctor to look at a form, a piece of paper, that someone else has filled in?”
However Ann Furedi, chief executive of the British Pregnancy Abortion Service, one of the main providers, said: “Abortion doctors provide an important service to women who are often in difficult circumstances. Their work is already intensely scrutinised, with clinics regularly inspected by the CQC.
“Mr Lansley says he is shocked and appalled by the practices he has uncovered.
“BPAS is shocked and appalled that Mr Lansley has found it necessary to inform journalists of alleged breaches of the abortion law before he has informed those responsible for providing the services that have been investigated, and before the investigation is concluded.”
Mr Lansley said: “The rules in the Abortion Act are there for a reason – to ensure there are safeguards for women before an abortion can be carried out. To protect women, the right checks and balances must be in place.
“The CQC has agreed to undertake unannounced inspections to identify the scale of this problem and we will set up a special team comprising of all the necessary regulators… to look at how we stamp out bad practice in abortion clinics.”